Mohammadi R, Ataei B
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Iran J Ped Hematol Oncol. 2016;6(1):43-51. Epub 2016 Mar 15.
Candida species are normal microflora of oral cavity, vagina, and gastrointestinal tract. They are the third most prevalent cause of pediatric health care-associated bloodstream fungal infection. This study aimed to provide an epidemiological feature of candidiasis and also presents an antifungal susceptibility profile of clinical Candida isolates among children.
During July 2013 to February 2015, 105 patients from different hospitals of Isfahan, Iran, were examined for candidiasis by phenotypic tests. Samples were obtained from nail clippings, blood, thrush, BAL, urine, oropharynx, skin, and eye discharge. The age range of patients was between 18 days to 16 years. Genomic DNA of isolates was extracted and ITS1-5.8SrDNA-ITS2 region was amplified by ITS1 and ITS2 primers. The PCR products were digested using the restriction enzyme MspI. Minimum inhibitory concentration (MICs) was determined using microdilution broth method according to the clinical and laboratory standards institute (CLSI) M27-A3 and M27-S4 documents.
Forty-three patients (40.9%) had Candida infection.The most clinical strains were isolated from nail infections (39.5%), and candidemia (13.9%). Candida albicans was the most prevalent species (46.5%). MICs ranges for amphotericin B, fluconazole, and itraconazole were (0.025-0.75 µg/ml), (0.125-16 µg/ml), and (0.094-2 µg/ml), respectively.
Due to high incidence of Candida infections among children, increasing of fatal infection like candidemia, and emersion of antifungal resistance Candida isolates, early and precise identification of the Candida species and determination of antifungal susceptibility patterns of clinical isolates may lead to better management of the infection.
念珠菌属是口腔、阴道和胃肠道的正常微生物群。它们是儿童医疗保健相关血流真菌感染的第三大常见病因。本研究旨在提供念珠菌病的流行病学特征，并呈现儿童临床念珠菌分离株的抗真菌药敏谱。
2013年7月至2015年2月期间，对来自伊朗伊斯法罕不同医院的105例患者进行了念珠菌病的表型检测。样本取自指甲剪、血液、鹅口疮、支气管肺泡灌洗、尿液、口咽、皮肤和眼部分泌物。患者年龄范围在18天至16岁之间。提取分离株的基因组DNA，并用ITS1和ITS2引物扩增ITS1-5.8SrDNA-ITS2区域。PCR产物用限制性内切酶MspI消化。根据临床和实验室标准协会（CLSI）M27-A3和M27-S4文件，采用微量稀释肉汤法测定最低抑菌浓度（MICs）。
43例患者（40.9%）发生念珠菌感染。最常见的临床菌株分离自指甲感染（39.5%）和念珠菌血症（13.9%）。白色念珠菌是最常见的菌种（46.5%）。两性霉素B、氟康唑和伊曲康唑的MICs范围分别为（0.025 - 0.75μg/ml）、（0.125 - 16μg/ml）和（0.094 - 2μg/ml）。
由于儿童念珠菌感染的高发病率、念珠菌血症等致命感染的增加以及抗真菌耐药念珠菌分离株的出现，早期准确鉴定念珠菌菌种并确定临床分离株的抗真菌药敏模式可能有助于更好地管理感染。
